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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 430757177
Report Date: 08/19/2026
Date Signed: 08/19/2026 10:41:35 AM

Document Has Been Signed on 08/19/2026 10:41 AM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN JOSE CC RO, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME:DIAZ, ALICIAFACILITY NUMBER:
430757177
ADMINISTRATOR/
DIRECTOR:		DIAZ, ALICIAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(408) 923-2085
CITY:San JoseSTATE: CAZIP CODE:
CAPACITY: 14TOTAL ENROLLED CHILDREN: 0CENSUS: 0DATE:
08/19/2026
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:25 AM
MET WITH:Alicia DiazTIME VISIT/
INSPECTION COMPLETED:
10:50 AM
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On 08/19/2026, Licensing Program Analysts (LPAs), Farida Raja and Tra Dinh met with Licensee, Alicia Diaz, for a case management visit in response to licensee's request to change the status of the license from inactive to active. The facility was on inactive status since 07/27/2026 and closed for operations 7 months prior to that due to home remodeling.

Licensee stated that there were no changes to the existing floor plan and the remodeling only included changing the flooring and repainting the home. The on and off limit areas to children remain the same. LPAs inspected the indoor and outdoor areas of the home for health and safety hazards. The home is clean and orderly, with heating/cooling and ventilation for safety and comfort of the children. LPAs observed a 2A10BC fire extinguisher and working smoke/carbon monoxide detector. The smoke detector in the daycare room was not observed to be functional but the carbon monoxide detector in the kitchen and combination smoke/carbon monoxide detector in Room #1 was observed to be functional. Fire extinguisher was last serviced on 01/06/2010. LPA reminded Licensee that fire extinguishers needs to be serviced annually and service tag or receipt of purchase needs to be maintained for review. LPA reminded Licensee that fire/disaster drills must be practiced at least once every 6 months and documented. Licensee stated that there are no weapons or no pets in the home. Knives were observed to be placed in high kitchen cabinets. LPAs observed medications on the kitchen counter, within reach of children. Licensee moved them to a high kitchen cabinet during the inspection. LPAs reminded Licensee that household tools, cleaning products, toxic agents, medications and sharp objects are to be inaccessible to children. LPAs reminded licensee that smoking, baby walkers, bouncers, jumpers and similar items are not allowed in family child care homes. LPAs observed sufficient materials, toys, and play equipment for the day care children.

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Gladys Kuizon
Farida Raja
DATE: 08/19/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/19/2026
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
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California Health & Human Services Agency
California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:
  • Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.
  • Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)
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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN JOSE CC RO, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME: DIAZ, ALICIA
FACILITY NUMBER: 430757177
VISIT DATE: 08/19/2026
NARRATIVE
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 Fireplace in the off-limit living room has a glass cover. Bathroom used by children was observed to be clean and in operating condition. LPAs observed several medications and ointments in the bathroom drawers and Licensee stated that she will place a child lock to make them inaccessible. LPA reminded Licensee that cleaning products, disinfecting wipes, toothpaste, shampoos, air fresheners, razors, mouthwash, perfumes and similar items need to be placed inaccessible to children.

LPA reviewed current facility sketch and confirmed that Room #1, daycare room, kitchen and one bathroom are used for providing care and are accessible to children. Licensee owns the home. Backyard was observed to be fenced and gated and there are no hazards to children present. Children will be dropped off and picked up through the right side entrance. No bodies of water were observed. Licensee was reminded that all water tables and wading pools need to be emptied immediately after use. Sandbox was observed to be free of hazards. LPAs observed age appropriate toys in the outdoor area. Shade is provide by awnings, umbrellas and canopies. Off limit areas outdoors: gated left side area and storage shed. Licensee has an active waiver to allow a fountain to remain in the front yard of the home. During the inspection LPAs observed plants in the fountain base but not in the lower basin.

Per Licensee, two adults and no minor children reside in the home. Days and hours of operation will be Monday through Friday, 6:00 AM and 6:00 PM. Licensee has current Pediatric CPR/First Aid certification which expires on 08/30/2027. Licensee stated that she has completed the Mandated Reporter Training but has left the proof in her daughter's home. Licensee has proof of immunization for pertussis. Licensee stated that she just obtained the influenza vaccination but could not provide proof. A review of staff records on 08/18/2026 indicates that all Facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions.

Licensee was reminded that all adults 18 and over living or working in the home, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a licensed Family Child Care Home. A civil penalty of $100.00 minimum/day for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

Licensee does not have liability insurance for the day care and will issue the Affidavit Regarding Liability Insurance for Family Child Care Home (LIC 282) to all families. Isolation of sick children, supervision of children, capacity options, transportation of children, requirements for reporting suspected child abuse, unusual incidents/injuries, heat-related illnesses, and requirements for assistant/substitute were also discussed.

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NAME OF LICENSING PROGRAM MANAGER: Gladys Kuizon
NAME OF LICENSING PROGRAM ANALYST: Farida Raja
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 08/19/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/19/2026
LIC809 (FAS) - (06/04)
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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN JOSE CC RO, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME: DIAZ, ALICIA
FACILITY NUMBER: 430757177
VISIT DATE: 08/19/2026
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Licensees stated that she will transport children. LPAs reminded Licensee that children cannot be left in parked vehicles unattended at any time, the motor vehicles used to transport children shall be maintained in safe operating conditions, and all vehicle occupants must be secured in an appropriate restraint system. Car seats shall only be used for transportation and shall not be used for sleeping.

Licensee stated that parents provide meals and snacks but she can provide them as well. Licensee stated that children will be provided store bought water.

Licensee was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

Licensee will use time outs as a form of discipline. LPAs reminded Licensee that time outs can only be one minute per age of child. Licensee understands that children's personal rights should not be violated; including no corporal punishment.

LPA discussed the Community Care Licensing website www.ccld.ca.gov which will provide access to resources such as forms, regulations, Provider Information Notices (PINs), and Quarterly Updates. LPA discussed Reporting Requirements as outlined in the regulations (Section 102416.2).

Pending the receipt of the following, an active license for a large family child care home will be granted:

1) Certificate of completed Mandated Reporter Training and proof of measles immunization for Licensee.

2) Proof of child locked bathroom drawers.

3) Proof of serviced/receipt of purchase of fire extinguisher.

4) Video proof of working smoke detector in the daycare room.

As a result of today's inspection, there were no deficiencies cited.

Exit interview conducted and report was reviewed with the licensee, Alicia Diaz. During the exit interview, Licensee, confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.

A notice of site visit was given and must remain posted for 30 days.

NAME OF LICENSING PROGRAM MANAGER: Gladys Kuizon
NAME OF LICENSING PROGRAM ANALYST: Farida Raja
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 08/19/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/19/2026
LIC809 (FAS) - (06/04)
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